Does HIV/AIDS still require an exceptional
response? That question framed the interactive discussion hosted by
the Caucus for Evidence-Based Prevention.
Mitchell Warren (AVAC) launched the
dialogue by quoting Richard Horton (The Lancet): "In 2031 will
there still be UNAIDS? Will we still need UNAIDS? What would
you do as the new Executive Director of UNAIDS?"
Helene Gayle (CARE USA) reminded
us that in 1995 the world was in emergency mode about HIV, but now we
need a different approach. "What we need today is to look at HIV prevention
as a marathon as opposed to a sprint."
"If I were Executive Director of
UNAIDS… I wouldn’t last very long," laughed Peter Figueroa (Jamaica’s
Ministry of Health). "… [M]uch more needs to be done… Prevention
is not just a science, but an art." We must figure out how to
bridge the gap between what people think is "morally right" and
condoning evidence that they think is "morally wrong" – such as
needle exchange or providing condoms to men in jail.
"What is wrong with the [HIV] response
in the present moment?" Nonkosi Khumalo (Treatment Action Campaign)
asked. She emphasized that the world must respond to the different needs
of different places. "One size does not fit all." She
then provoked her colleagues: "PEPFAR money is not responsive to women
– who carry the brunt of HIV."
Vuyiseka Dubula (Treatment Action Campaign)
added, "We must prioritize investments for women, especially evidence-based
prevention. We will not have an HIV-free generation if we encourage
things that don’t work."
"If ever there was an idea that’s
not evidence-based, it’s that better evidence leads to better policy,"
said Elizabeth Pisani, author of The Wisdom of Whores. She prompted
the audience to address ways to overcome the political barriers to using
Looking forward, the panelists hoped
that women will take the lead, HIV will be treated as a development
issue, and we will focus on prevention efforts where they are needed